ACLS POST TEST EXAM 3 NEWEST VERSION 2026-2027
ACTUALQUESTION AND CORRECT DETAILED ANSWERS
RATED A GRADE.
A 45-year-old male had coronary artery stents placed 2 days ago.
Today he is in severe distress and reporting "crushing" chest
discomfort. He is pale, diaphoretic, and cool to the touch. His radial
pulse is very weak, blood pressure is 64/40, respiratory rate is 28
breaths/min, and SpO2 is 89% on room air. Despite 2 defibrillation
attempts, the patient remains in ventricular fibrillation. Which drug
and dose should be given?
a. Lidocaine 1 mg/kg
b. Amiodarone 300 mg
c. Epinephrine 1 mg
d. Atropine 1 mg
CORRECT ANS: c. Epinephrine 1 mg.
Expert Rationale: In the management of ventricular fibrillation (VF) or
pulseless ventricular tachycardia (pVT) cardiac arrest, the initial priority
is high-quality CPR and defibrillation. After the second defibrillation
attempt, the next step is to administer epinephrine 1 mg IV/IO.
Epinephrine is a potent vasoconstrictor that increases coronary and
cerebral perfusion pressure during CPR, improving the chances of
ROSC. The 1 mg dose is the standard adult dose given every 3-5
minutes during cardiac arrest. Amiodarone 300 mg is given for
refractory VF/pVT after the third shock.
,A 45-year-old male had coronary artery stents placed 2 days ago.
Today he is in severe distress and reporting "crushing" chest
discomfort. He is pale, diaphoretic, and cool to the touch. His radial
pulse is very weak, blood pressure is 64/40, respiratory rate is 28
breaths/min, and SpO2 is 89% on room air. Despite the drug provided
above & continuous CPR, the patient remains in ventricular
fibrillation. Which drug should be given next?
a. Atropine 1 mg
b. Magnesium sulfate 1 g
c. Amiodarone 300 mg
d. Epinephrine 1 mg
CORRECT ANS: c. Amiodarone 300 mg.
Expert Rationale: After the initial dose of epinephrine and a third
defibrillation attempt, if the patient remains in VF/pVT, the
recommended antiarrhythmic agent is amiodarone 300 mg IV/IO.
Amiodarone is the preferred antiarrhythmic for refractory VF/pVT. It
works by prolonging the refractory period and stabilizing cardiac
membranes. The initial dose is 300 mg, and a second dose of 150 mg
may be given if VF/pVT persists. Lidocaine is an alternative but is
considered second-line. Magnesium is given for torsades de pointes.
A 45-year-old male had coronary artery stents placed 2 days ago.
Today he is in severe distress and reporting "crushing" chest
discomfort. He is pale, diaphoretic, and cool to the touch. His radial
pulse is very weak, blood pressure is 64/40, respiratory rate is 28
breaths/min, and SpO2 is 89% on room air. The patient has return of
spontaneous circulation (ROSC) and is not able to follow commands.
, Which immediate post-cardiac arrest care intervention do you choose
for the patient?
a. Extubate
b. Check glucose
c. Give epinephrine
d. Initiate targeted temperature management
CORRECT ANS: d. Initiate targeted temperature management.
Expert Rationale: After ROSC, the patient is comatose (not following
commands). The 2020 AHA guidelines recommend targeted
temperature management (TTM) for comatose patients after ROSC.
TTM involves cooling the patient to a target temperature of 32°C to
36°C for at least 24 hours. This neuroprotective strategy reduces the
risk of neurological injury and improves survival. Checking glucose (b) is
important, but TTM is the priority intervention for this comatose post-
cardiac arrest patient.
A 45-year-old male had coronary artery stents placed 2 days ago.
Today, he is in severe distress with crushing chest discomfort. He is
pale, diaphoretic, and cool to the touch. His radial pulse is very weak.
Blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min,
and SpO2 is 89%. The cardiac monitor initially showed ventricular
tachycardia, which quickly changed to ventricular fibrillation. What
would you have done first if the patient had not gone into ventricular
fibrillation?
a. Give atropine 1 mg
b. Establish IV access
ACTUALQUESTION AND CORRECT DETAILED ANSWERS
RATED A GRADE.
A 45-year-old male had coronary artery stents placed 2 days ago.
Today he is in severe distress and reporting "crushing" chest
discomfort. He is pale, diaphoretic, and cool to the touch. His radial
pulse is very weak, blood pressure is 64/40, respiratory rate is 28
breaths/min, and SpO2 is 89% on room air. Despite 2 defibrillation
attempts, the patient remains in ventricular fibrillation. Which drug
and dose should be given?
a. Lidocaine 1 mg/kg
b. Amiodarone 300 mg
c. Epinephrine 1 mg
d. Atropine 1 mg
CORRECT ANS: c. Epinephrine 1 mg.
Expert Rationale: In the management of ventricular fibrillation (VF) or
pulseless ventricular tachycardia (pVT) cardiac arrest, the initial priority
is high-quality CPR and defibrillation. After the second defibrillation
attempt, the next step is to administer epinephrine 1 mg IV/IO.
Epinephrine is a potent vasoconstrictor that increases coronary and
cerebral perfusion pressure during CPR, improving the chances of
ROSC. The 1 mg dose is the standard adult dose given every 3-5
minutes during cardiac arrest. Amiodarone 300 mg is given for
refractory VF/pVT after the third shock.
,A 45-year-old male had coronary artery stents placed 2 days ago.
Today he is in severe distress and reporting "crushing" chest
discomfort. He is pale, diaphoretic, and cool to the touch. His radial
pulse is very weak, blood pressure is 64/40, respiratory rate is 28
breaths/min, and SpO2 is 89% on room air. Despite the drug provided
above & continuous CPR, the patient remains in ventricular
fibrillation. Which drug should be given next?
a. Atropine 1 mg
b. Magnesium sulfate 1 g
c. Amiodarone 300 mg
d. Epinephrine 1 mg
CORRECT ANS: c. Amiodarone 300 mg.
Expert Rationale: After the initial dose of epinephrine and a third
defibrillation attempt, if the patient remains in VF/pVT, the
recommended antiarrhythmic agent is amiodarone 300 mg IV/IO.
Amiodarone is the preferred antiarrhythmic for refractory VF/pVT. It
works by prolonging the refractory period and stabilizing cardiac
membranes. The initial dose is 300 mg, and a second dose of 150 mg
may be given if VF/pVT persists. Lidocaine is an alternative but is
considered second-line. Magnesium is given for torsades de pointes.
A 45-year-old male had coronary artery stents placed 2 days ago.
Today he is in severe distress and reporting "crushing" chest
discomfort. He is pale, diaphoretic, and cool to the touch. His radial
pulse is very weak, blood pressure is 64/40, respiratory rate is 28
breaths/min, and SpO2 is 89% on room air. The patient has return of
spontaneous circulation (ROSC) and is not able to follow commands.
, Which immediate post-cardiac arrest care intervention do you choose
for the patient?
a. Extubate
b. Check glucose
c. Give epinephrine
d. Initiate targeted temperature management
CORRECT ANS: d. Initiate targeted temperature management.
Expert Rationale: After ROSC, the patient is comatose (not following
commands). The 2020 AHA guidelines recommend targeted
temperature management (TTM) for comatose patients after ROSC.
TTM involves cooling the patient to a target temperature of 32°C to
36°C for at least 24 hours. This neuroprotective strategy reduces the
risk of neurological injury and improves survival. Checking glucose (b) is
important, but TTM is the priority intervention for this comatose post-
cardiac arrest patient.
A 45-year-old male had coronary artery stents placed 2 days ago.
Today, he is in severe distress with crushing chest discomfort. He is
pale, diaphoretic, and cool to the touch. His radial pulse is very weak.
Blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min,
and SpO2 is 89%. The cardiac monitor initially showed ventricular
tachycardia, which quickly changed to ventricular fibrillation. What
would you have done first if the patient had not gone into ventricular
fibrillation?
a. Give atropine 1 mg
b. Establish IV access
